The document summarizes an outbreak of the Nipah virus in India in 2018. Key points: - Nipah virus is a zoonotic virus that was first identified during an outbreak in Malaysia in 1999. Fruit bats are the natural host. - An outbreak occurred in Kerala, India in 2018, the third outbreak in India after 2001 and 2007. Rapid urbanization and climate change may have contributed to the reemergence. - Symptoms in humans range from mild flu-like symptoms to severe encephalitis. There is no vaccine and treatment involves intensive supportive care. Ribavirin may help but its efficacy is limited. Further research on vaccines and treatments is ongoing.

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IJPCR |Volume 2 | Issue 1 | Jan – Jun- 2018
www.ijpcr.net
Review article Clinical research
Outbreak of Nipha virus in India
Dr. N. Sriram, Ramoju Kishore Kumar
Holy Mary Institute of Technology and Science, College of Pharmacy, Keesara, Bogaram, Telangana
200253
*
Address for correspondence: Ramoju Kishore Kumar
ABSTRACT
Nipah virus is an newly out broke virus from the animal species the exact reason for the virus out bake was not
known clearly some scientist are concluded the point regarding the reoccurrence of the virus in the India after a gap
of 8 years of last impact, this virus is mainly spreading because of the a kind of the cattle pigs and from the infected
fruit bat. At first virus has been found in the region of the south East Asia islands later few developed countries has
taken a step forward in order to control or eradicate the virus while few countries has left the solution for the
problem. Recently a week back the virus has been observed in the south state of the India. As it was known fact that
this virus is a zoonosis. Various countries are a step ahead in the research. When compared to the west part of the
world the impact of the disease is more in the eastern part of the world. There is no particular vaccination for this
virus, diagnosis for the disease is also a complex task.
Keywords: Pteropodidae family, Fruit bat, Henipavirus, Ribavirin
INTRODUCTION
Nipah virus is a newly outbreak zoonosis
(disease which can be transmitted to humans from
animals) natural host of this virus is fruit bats of
pteropodidae family. Nipah virus was first found in
year 1999 in pig farmers of kampong sungai Nipah
region in Malaysia country. Transmission of the
disease might be from direct contact with ill pigs’
throat or nasal secretion, consumption of fruits or
vegetables contaminated with urine or saliva from
infected fruit bat.
Signs and symptoms of the infected Human will
develop influenza like symptoms like fever,
headache, myalgia, sore throat and vomiting along
with this condition drowsiness and some
neurological changes. Initially patients will be
asymptomatic later they develop above mentioned
conditions. Encephalitis and seizures occur in
severe cases which progressively leads to coma
within 24 to 48 hours. The incubation period is
between 4 to 14 days. People who survived from
acute encephalitis make a full recovery, but long
term neurologic conditions have been reported in
survivors. [1-5]
Morphology
Nipah virus is a newly created henipavirus
genus. Its size is nearly 40 to 600 nm in diameter.
Inside it contains a linear ribonucleprotein (RNP)
International Journal of Pharmacology and
Clinical Research (IJPCR)
ISSN: 2521-2206

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containing of negative sense single stranded RNA.
RNP contain three different type of protein
materials they are nucelocapsid proteins (N),
phosphoproteins (P) and polymerase protein (L).
The virion(complete virus particle) is covered with
a traditional lipid bilayer but “spiked” with fusion
proteins(F). The fusion proteins are responsible for
fusing the viral membrane to the host membrane
eliciting the release of the contents of the virion.
The receptor-binding glycoporteins are particular
bind only to Ephrin B2 (EFNB2) surface proteins
which is surface proteins are highly sustained
across the mammalian lineage. Not only above
mentioned proteins but also proteins like C, V, and
W, are also present in the cytoplasm and involved
in transcription and replication. Actually in order to
activate the immune system intercellular
communication is necessary which leads to get rid
of the pathogens. Proteins like C, V, and W
proteins has a special property of anti-interferon
which will block the signalling, the exact
mechanism of this proteins is not known and the
exact structure of the virus is not understandable.
[1, 2]
NiV Virus history
First outbreak of the Niv virus is happened in
Singapore in the 20th
century as per the data
available as of then around 250- 300 people has
thougt to died due t the impact of disease. At
present the outbreak of the Niv virus is high in the
regions of the south- East Asia.in the south-eastren
countries like India and Bangladesh has reported
human cases of Nipah virus encephalitis. In other
south-eastern countries like Indonesia, Thailand has
detected antibodies against NiV in the bat
population and their source has been isolated,
whereas the status of this infection is not found or
not detected in the flying bats found throughout the
region.
When compare to the india Bangladesh is much
familiar with the virus in the year 2001 it was first
identified in one of the Bangladesh district after
that in every its was commonly and up to March
31, 2012 a total of 209 human cases of NiV
infection in Bangladesh were reported; 161 (77%)
of them died. [3]
As per geographical distance between
Bangladesh and India is very near. In the year 2001
first outbreak of the disease is identified in the west
Bengal district which is very close to the
Bangladesh country. A second outbreak was
reported in 2007 in Nadia district of West Bengal.
Around 30 cases of fever with acute respiratory
distress and/or neurological symptoms were
reported and five cases were fatal. All five fatal
cases were found to be positive for NiV by RT-
PCR. Recently in the 2018 the third outbreak of
this virus has happened but this time this virus has
been occurred in the southern state of the india that
is kerala it may be due to rapid urbanization, along
with changes in the climatatic conditions over the
past few years has played an vital role in the
reoccurrence of the NiV virus in the India. Health
and natural science experts are trying to creak the
puzzle of reoccurrence after the 2001and 2007 in
indin by the time infection has been claimed over
10 live with in short period of time. A.C. Dhariwal,
adviser, national vector borne disease control
programme has given an statement regarding the
NiV virus “We are looking at the causes of the re-
emergence of the virus. Specialized team at our
strong network of laboratories are trying to find out
the causes of outbreak, India is witnessing a rapid
urbanization and animals and birds including bats
are losing their natural habitats. In recent years,
humans are animals are coming in contact with
each other which is also causing outbreak of
diseases such as Nipah,” he said. Juliet Pulliam,
director for South African DST-NRF Centre of
Excellence in Epidemiological Modelling and
Analysis (SACEMA) at Stellenbosch University,
warned the virus is more easily spread from people
with respiratory symptoms. She said: “Nipah virus
can be transmitted from person to person, but this
transmission is not very efficient. When
transmission does occur, it is usually to close
contacts who have been exposed to the bodily
fluids of a person who is sick. People with Nipah
virus are more likely to transmit the virus if they
have respiratory symptoms, such as difficulty
breathing.”
Diagnosis for NiV virus
Screening for the subjects with the NiV can be
made during the initial and convalescent phases of
the disease by using a combination of tests. Real
time polymerase chain reaction (RT-PCR) from
cerebrospinal fluid, nasal swabs, urine, and blood
should be performed in the primary stages of

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disease. Later antibody detection by ELISA (IgG
and IgM) can be performed. In serious cases
immunohistochemistry test on the tissues collected
while autopsy will be only way to validate the
diagnosis of the disease. [10]
Treatment for NiV virus
As of now, there is no particular vaccine
available purely for the treatment of Nipah Virus.
The only way to treat this virus is through intensive
supportive care.
Since drinking raw date palm sap bitten by a bat
can also cause NiV, it is safe to say that you should
stay from consuming date palm for some time.
Hospitals also need to raise awareness about
symptoms and transmission to avoid human-to-
human infections in such settings. Detection is
another issue with NiV and anyone who feels the
symptoms should get tested thoroughly from a
recognized facility.
Antiviral treatment is considered as the one of
the best option but there is no licences for in
treating the henipaviruses but few studies has been
suggested this therapy as best in the animal model.
One of the anti-viral drug ribavirin is considered as
a first line treatment for assumed viral infections of
unknown origin, it exhibits best action towards the
virus containing DNA and or RNA agents in them
and is an accepted or approved treatment for
several viral infections including respiratory
syncytial virus and viral hemorrhagic-fevers. In
vitro studies have shown that ribavirin is effective
against both Hendra and Nipah virus replication.
Along with this chloroquine anti-malaria drug is
considered to stop the critical proteolytic
processing which is essential for the maturation of
the virus but recent animal studies has proved that
the anti-viral drug ribavirin treatment is not as the
best treatment for the curing of the disease but this
drug only delayed effect of the disease. Few
researches has been done on the m102.4 mAb agent
for the Hendra and Nipah virus in animals it has
given the positive results [8, 9]. By seeing the
Impact of the disease in the society, Australian
health authorities’ has obtain m102.4 as a possible
consideration for the use of therapeutic option for
the disease condition even though clinical trials
data in human has not been obtained and safety
data of the mAb in humans was not clear. As the
research regarding the m102.4 agent has been done
extensively in the 21 century Queensland
Government, Queensland Health, to allow health
authorities to manufacture m102.4 for its potential
use on a compassionate basis in future cases of
high-risk human exposure [9]. Later this drug has
been administered to an individual but no side
effects or adverse drug effect has been found for
that individual.
Vaccination status of NiV virus
Currently there is no particular vaccine for the
NiV virus but all the research and development
activities of the NiV vaccines are in the pre-clinical
stage having been tried in the hamster, ferrets. The
most advanced vaccine Equivac HeV® that is
formulated with a proprietary immune stimulatory
complex adjuvant and some other cross immune
protective agents has been developed but the exact
activity and the effect on the NiV virus is not so
clear. So in order to control the current condition in
India scientist around the globe are rushing their
research to find the vaccination for the virus.
CONCLUSION
M102.4 is not a vaccine for NiV virus but it is a
human Monoclonal Antibody (M 102.4) it is drug,
developed by Dr Christopher C Broder from
Australia even, name for this is not given because it
is still in clinical trials. Effect of the m102.4 is
found in the in vitro. In order to control the current
situation in India main cell line by how the mab
was prepared should be studied and understand in
detail by the ICMR and other research
organizations. If this happens then India can also
produce the antibiotics for Niv virus.
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